Is there a safe area for the axillary nerve in the deltoid muscle? A cadaveric study
Is there a safe area for the axillary nerve in the deltoid muscle? A cadaveric study
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DOI：
10.2106/jbjs.e.01375
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发表时间：
2006-11-01
影响因子：
5.3
通讯作者：
Cift, Hakan
中科院分区：
文献类型：
--
作者：
Cetik, Ozgur;Uslu, Murad;Cift, Hakan
背景：几位作者已经定义了各种所谓的三角肌劈裂切口的安全区。本研究的第一个目的是调查腋神经到肩峰的距离及其与臂长的关系。第二个目的是确定一个安全的区域腋神经在手术解剖的三角肌。方法：24个肩膀的防腐成人尸体被列入研究。测量肩峰前缘至腋神经走行的距离，并记录为前方距离。从肩峰后缘到腋神经的行程进行相同的测量，并记录为每个肢体的后方距离。对臂长与各肢体前、后距进行相关分析。结果：平均臂长为30.40 cm，平均臂长为30.40 cm。平均前方距离为6.08 cm，平均后方距离为4.87 cm。臂长与前距（r = 0.79，p < 0.001）和后距（r = 0.61，p = 0.001）均显著相关。腋神经在沿着走行的每一点与肩峰的距离都不恒定。平均前指数为0.20，平均后指数为0.16。结论：本研究描述了腋神经上方的一个安全区域，该区域呈四边形，其外侧边缘的长度取决于个体的臂长。在肩部手术中，使用这个安全区域可以为腋神经提供安全的暴露。
Background: Several authors have defined a variety of so-called safe zones for deltoid-splitting incisions. The first aim of the present study was to investigate the distance of the axillary nerve from the acromion and its relation to arm length. The second aim was to identify a safe area for the axillary nerve during surgical dissection of the deltoid muscle.Methods: Twenty-four shoulders of embalmed adult cadavers were included in the study. The distance from the anterior edge of the acromion to the course of the axillary nerve was measured and was recorded as the anterior distance. The same measurement from the posterior edge of the acromion to the course of the axillary nerve was made and was recorded as the posterior distance for each limb. Correlation analysis was performed between the arm length and the anterior distance and the posterior distance for each limb. The ratios between arm length and the anterior and posterior distances were calculated for each case and were recorded as an anterior index and a posterior index.Results: The average arm length was 30.40 cm. The average anterior distance was 6.08 cm, and the average posterior distance was 4.87 cm. There was a significant correlation between arm length and both anterior distance (r = 0.79, p < 0.001) and posterior distance (r = 0.61, p = 0.001). The axillary nerve was not found to lie at a constant distance from the acromion at every point along its course. The average anterior index was 0.20, and the average posterior index was 0.16.Conclusions: The present study describes a safe area above the axillary nerve that is quadrangular in shape, with the length of the lateral edges being dependent on the individual's arm length. Using this safe area should provide a safe exposure for the axillary nerve during shoulder operations.